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Home My WebLink About4235-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z. 3757 .... Date ... F.~b:~a~y ..... ~,8, ....... ,19. ?0. THIS CERTIFIES that the building located at P~.t.. Rd.. o~'£. 8/~ ....... Street Ind,.an Neck Lane Map No... ~ ...... Block Bio... ~ .... Lot No.. Pe~o~.c,..l~e~ .Yer~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... April.. 8.,..., 19..69 pursuant to which Building Permit No. dated ......... A.p~:.:~,. ~..2., .... , 19..69, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... l~.~.V&te, one. £a~,1¥..d~ell~ng ................................ The certificate is issued to . .. ~4rso. Hax~.ey..G.. Red&,~,~ ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .P.e.~.~..u.a.~_v. FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, FI. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 235 Z Permission is hereby granted to: ............ :~.,...~..,...~.~h..~Z~..~r.~..~.~...Eedden ................... ~0~o3~ ......................................... to ............ ~f~....~t.e:~...¢~... f.e~,~:..~:~¢e!J,~ ........................................................................ at premises located at ............. ,~.~...~.0..~..~......~..~.:~......~.~..~.~..t[~,..~,~.~.~...~.~ ........................................ .................................................. ~.~.~i.c ......... N.~.~ .......................................................................... pursuant to application dated .............................. Ap~.l;L....~ .......... , 19..~-~1., and approved by the Building Inspector. Fee $ ]..0. ~..0..0.. ........... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date February Bldg. Permit No, TO WHOM IT MAY at CONCERN: The sewage disposal facilities for a structure Private Road off Sou%h Side Indian Neck Lane (Give deed location) located Peconi_c~ New York have been inspected by this department and found to be satisfa~toryo District Engineer District Engineer /111£,c ~N OF SOUTH~O ~UILDING DEPARTMENT TOWN CLERK'S OFFICE S~TH~D, N. Y. Examined .......... 4/ ............................ , Approved ........................................ , 19-.: ....Permit No. ~./...:~.:i:.*.~:...~ ~'~¢~ '~'~" uisappr~ed a/c .............................................................................................. ~.~ n ~ ~ ~ ................ ...... .................... ....... (Building ~nspector) ~r~ '~ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showin.g, location ef lot and of buildings on premises, relationship to adjoining premises or public Streets or areas, and giving a detaded descriPtion of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this al~plication may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shcdl be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy Shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ~ \, (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which pr.oposed work will be done. Map No.: ..~ ....... ~....~. ............. ;...~..'.i?~bt~ , Street and Number · · ~ ............ ' .. ..~ ..................... /~/ ~ (~/O - Municipality 2. State existing use and occupancy of premises and 'i~{end'e~ Use ~n'd occupancy of proposed construction: :. .................... : ........................ :..: .................................... /~.,,~,,-~. ~, r~*~~' ~ .. 3. Nature of work (check which applicable): New.Bui'lding ; ........ .K...... Adclition .................. Alteration .................. Repair .................. Removal .................. ' Demolition ............. ..... Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling; number of dwelling units ............. .~.., ......... Number of dwelling units on each floor ............................ If garage, number of oa~ ............................. ~ ......................... i .................. :~ .......................... ~ ......... ,.. · 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... ~. Rear ................................ Depth .................... Height ........................ Number of Stories .................. '.~ ............................................................................................. Dimensions of same structure with alterations or ada't'ons Front .~ .................................. Rear ............................ Depth .......... /.. .................. Height ............................ Number of Stories ................................ Height ...../..~(~. ....... Number of Stories ......... /. ............................................................................... ~ .......................... 9. Size of lot: Front 10. Date of Purchase .......... ~....~..~..~.. .......................... Name of Former Owner ......... ~ ................................ 11. Zone o? use district in which premises are situated ........ ~... ............... ; ..................................................................... 12, Does proposed construction violate any zoning law, ordinance or regulation? .......... ,~...~.. ........................................ Name of Architect ..............w. ..................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinct'ly oil buildings, whether existing or proposed, and indicate all set-back dimensions from ~operty lines. Give street and block number or description according to deed, and show_ street names and indicate ether interior or corner lot. |! [Name at inaiv,aual signing applicationl above named. He is the ............................. ,..4:~T-~i:~ ..................................... ; ................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make o~nd file- this application; that all statements contained in this application are true to the best of his knowledge and belief; end that the work will be performed in the manner set forth in the application- filed therewith. Sworn to before me this _ NotaryPublic ,/,/tt~.~.~ ...... County~t~ (Signatare of applicant) ELIZABETH ANN NEVILLE ~ ,~' - NOTARY pUBLIC, State of New York No. 52-8~25850, Suffolk Te~m Expires March 30,